Kelly, Jennifer Jo

Kelly, Jennifer Jo is an individual health care provider with primary practice located at 3333 Burnet Ave Ml 5006 Diabetes Clinic, Cincinnati OH 45229. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Kelly, Jennifer Jo can be contacted via phone (513) 636-9079.

Contact Information

Primary practice address
3333 Burnet Ave Ml 5006 Diabetes Clinic Cincinnati OH 45229
Phone: (513) 636-9079
Fax: (513) 636-7576
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X COA.08014-NP Ohio
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X COA.08014-NP Ohio

Profile Details

NPI number 1063460558
LBN Legal business name Kelly, Jennifer Jo
Credentials RN, CNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Sep 30th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063460558 NPPES
Ohio MEDICAID 2656951

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